Individual
MR. JEAN EDWARD MARCHESSEAULT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
12606 E MISSION AVE, SPOKANE VALLEY, WA 99216-3421
(509) 473-5723
Mailing address
600 W HUBBARD ST APT 41, COEUR D ALENE, ID 83814-2271
(208) 669-3830
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA1654
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RN403089
—
CA
Enumeration date
03/29/2006
Last updated
12/05/2008
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